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Reduced quality of life with reflux diseases
Patients who suffer from reflux disease have a significantly lower health-related quality of life (HRQoL) than individuals who don’t, as highlighted in three recently published articles.1-3
The significant distress caused by reflux diseases, such as gastro-oesophageal reflux disease (GORD), is well known, though the magnitude of the problem is probably underestimated. The considerable burden that reflux symptoms like heartburn confer on patients diagnosed with GORD worsen as symptoms get more frequent and severe.1 Furthermore, patients with untreated GORD tend to report worse pain, lower social function and emotional well being than patients with other chronic diseases, such as diabetes or hypertension.2
A marked improvement in HRQoL can only be achieved by a complete and sustained resolution of symptoms, in particular, heartburn. This makes evaluation of HRQoL in patients with GORD a particularly important outcome measure for monitoring disease progression and assessing the effect of treatment. As well as questionnaires that measure quality of life in general, several valid and reliable disease-specific questionnaires are available, including the Quality of Life in Reflux and Dyspepsia (QOLRAD) and the Gastro-oesophageal Reflux Disease–Health-Related Quality of Life (GORD–HRQL).2
But how well do these questionnaires perform for other types of reflux diseases, whose effect on HRQoL also need monitoring? For example, although laryngopharyngeal reflux (LPR) disease shares the signs and symptoms of GORD, there is considerable variance in their incidence and severity. Most notably, only 40% of LPR patients actually report any heartburn. In further contrast to GORD, LPR can significantly affect the voice, and so LPR symptoms may lead to substantial psychological, emotional, and social problems with negative impact on self-esteem and relationships.3 Lenderking et al argue that these differences mean that GORD-specific HRQoL measures are less sensitive to changes in HRQoL in LPR, largely because questions on heartburn and regurgitation are not as relevant to patients with LPR.3 These problems would need to be captured. Lenderking et al, therefore, call for a new measure that specifically addresses the impact LPR has on patient HRQoL and that would contribute to the evaluation of treatment strategies for LPR.
Read more about GORD and its management
Read more about LPR
References:
1. Jones R, Horbach S, Sander P, Ryden-Bergsten. Heartburn in Patients with gastro-oesophageal reflux disease in Germany and Sweden. A study on patients’ burden of disease. Pharmacoeconomics. 2003;21:1091-02.
2. Shaw M, Crawley J. Improving health-realted quality of life in gastro-oesophageal reflux disease. Drugs. 2003;63:2307-16.
3. Lenderking W, Hillson E, Crawley J, Moore D, Berzon R, Pashos C. The clinical characteristics and impact of laryngopharyngeal reflux disease on health-related quality of life. Value in Health. 2003;6:560-5
